NORFOLK, Va. - Every musical note that drifts through the air offers a moment of relief for Ryan Featherer.
"That's another reason why I love my job because for those hour-and-a-half to three hours a day, I'm not thinking about it," he said.
Featherer is an orchestra teacher at Maury High School. Music, he said, "is his medicine."
When he's teaching he's not thinking about managing the pain or fighting with the insurance company. In 2003 Featherer was diagnosed with multiple sclerosis, a chronic disease that affects the central nervous system. He's in pain everyday.
"You feel it as soon as you put your feet on the ground and it doesn't stop. It just never stops," he said.
Until one day when it did.. almost.
The father of two participated in a week-long clinical trial where a spinal cord stimulator, made by Medtronics, was implanted in his body.
"[The doctor] flipped it on and I'm laying with my head looking at the ground and I just started crying. I said, 'I can't feel it' and they said 'oh no what do you mean you can't feel it?' I said 'no I can't feel the pain' and then everyone just got quiet in the room," he said.
On a scale from one to ten, Featherer said his pain reduced from an eight to a two, which is something he hasn't felt since 2002.
However, the relief was short-lived.
When the trial was over, the stimulator was removed and his pain came back. Featherer said the insurance company told him the device was not "medically necessary."
"I want to give [my kids] the best life they can have. I want to give my students [and] my family the best life they can have and I had it and then it went away and then here's a chance for me to have it again and they're saying no. Why are they saying no?" Featherer said.
He said he kept records of everything: 1,200 pages of every pain medication, treatment, and therapy session. Featherer said the paperwork was supported by his doctors and proved why he needed the device.
The insurance company still denied it.
The News 3 Problem Solvers wanted to see how often this happens. We found a 2021 report from the State Corporation Commission's Bureau of Insurance that surveyed 16 health carriers.
Those carriers reported receiving "a total of 36,784,134 claims received with 4,041,253 (11.99%) of claims being denied. This is a lower denial rate from the previous report’s denial rate of 12.8%."
Katha Treanor, Communications Manager for the State Corporation Commission said, "insurance companies, if they deny a claim, they need to tell you why they denied it."
Consumers, however, can appeal their decision, like Featherer did.
According to the 2021 SCC report, 5,272 medical/surgical internal appeals were processed and in 1,664 cases the denial was overturned. If a denial isn't overturned after the internal appeals process, consumers can ask for an external review. In external reviews, the SCC reports 137 were performed and 60 denials were overturned.
"Keep track of any billing statements [involved with] your claim [and] any communications [that you have had] with the insurance company. If you contact them by phone, keep records of that [including] who you talk to, when you talk to them, and basically what you discussed," Treanor said. "The more information the Bureau has, the better it's going to help them to make a decision."
Featherer did all of this and still his claim was denied, so his students stepped in.
"I get a phone call one Friday afternoon. It was the assistant to the CEO of Anthem telling me that my students had written letters. There was a letter writing campaign going to her," he said.
After this show of support, recognition on Instagram from Alec Baldwin and two GoFundMe's, Featherer received a letter in the mail that said:
"Recently you or your doctor asked us to review a request for the service listed in the table and the request has been approved."
"This was the appeal that my students fought for," Featherer said.
And the fight was worth it. Their beloved orchestra teacher is scheduled for the procedure on July 27th.
"My goal, when this is over, is to pay it forward. Someone out there is going to need some help and I want that someone to reach out to me," he said.
As of Thursday, the GoFundMe had raised more than $27,000. The insurance company said they will pay 80% of the cost, but even that remaining 20% out-of-pocket will be expensive. Featherer said he's counting on the money to help with the cost of equipment and any device maintenance.
He told Problem Solver Erin Miller that he's excited to get back to his students in the Fall and even run a 5K with his daughter.
Below are resources if you are having issues with your insurance company:
